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Senate panel weighs who should pay accreditation costs for developmental-disability providers
Summary
Members of the Senate Human Services Committee questioned Department of Health and Human Services officials about accreditation costs, past reimbursements and whether to include accreditation in provider rates or fund it through grants in Senate Bill 2192.
Senate Human Services Committee members pressed Department of Health and Human Services officials on the cost and payment options for accreditation of developmental-disability (DD) service providers as they discussed Senate Bill 2192 on accreditations.
The committee heard from Tina Bay, director of the Developmental Disabilities Section at the Department of Health and Human Services, who gave a brief history of state support for accreditation and cost estimates. "In 2019, we had $492,000 in the DD section budget to cover accreditation," Bay said, adding that the Legislature provided "approximately $324,000" for the 2021–23 biennium and that "in the 2023 biennium, nothing was appropriated for accreditation." Bay also told senators that the Council on Quality and Leadership (CQL) charges "around that $20,000 to $30,000" per accreditation, with additional travel-related expense varying by agency size.
Committee members raised two recurring policy questions: whether the state should continue to pay accreditation fees and, if not, whether accreditation costs should be folded into provider rate calculations. "So the obvious easy answer is that it should be in the budget," a committee member said during debate, while others suggested including accreditation as an allowable cost in the state's prospective rate-setting methodology so the federal match (FMAP) would help cover state expense.
Bay told the committee the department had changed its approach this year by allowing providers to choose from five approved accrediting entities, a change meant to introduce competition and potentially lower costs. She warned, however, that some accreditors, such as CQL, accredit organizations rather than single services, which can require an agency-wide review even if only one program needs accreditation. "They said this is how we do business across the country, and they wanted to follow that same practice for us," Bay said about CQL's position.
Senators pressed for numbers and context: committee members noted the bill as drafted contained roughly $240,000 in grants intended to help with accreditation costs and asked whether that amount would be sufficient. Bay said she did not know where that exact figure came from and that the department would need to analyze providers' accreditation timelines — many accreditations occur on a four-year cycle — before estimating a true fiscal need. Bay said the department previously included accreditation in the retrospective cost-based rates and that the 2018 reimbursement methodology change affected how accreditation was treated.
Committee members also discussed whether allowing multiple accrediting bodies would complicate oversight and make comparisons across providers difficult, or whether competition would prevent a single-accreditor monopoly and reduce price pressure. "If you only allow one accrediting body in, they get the monopoly, and they have no incentive to keep their cost down," one senator said. Another senator suggested using a rate review as a transitional strategy: grant funding for the current biennium, paired with a directed department rate review to determine whether accreditation should become an embedded, ongoing rate component.
Bay told the committee the department could provide more detailed estimates and a proposed timeline for a rate review, and she said staff would return with that information. Senators asked the department to supply the department's past spending numbers, a provider-by-provider timeline of upcoming accreditation needs, and an explanation of which types of providers (DD, aging, psychiatric residential treatment) are subject to which accrediting standards.
The discussion did not produce a final committee vote on SB 2192 during the hearing; committee members directed staff and department officials to return with detailed cost estimates and options for embedding accreditation costs in rates or funding them as grants.
The committee scheduled follow-up work so senators could weigh short-term grant funding against longer-term rate adjustments that could draw federal match dollars and spread costs across payment systems.
